Dr. Cameron Askew is a board-certified general surgeon. She cares for patients with a wide range of surgical problems, especially men and women seeking bariatric (weight-loss) surgery. She practices at Brookwood Baptist Medical Center here in Birmingham.
Dr. Askew is a life-long Alabamian. She is a graduate of Florida State University and the University of Alabama School of Medicine (UAB). She completed her general surgery training in the Baptist Health System. She is married with two stepsons, two dogs, and an active role in promoting obesity education; so, she understands her patients’ struggles to prioritize health in their busy lives.
We recently asked Dr. Askew to share some information about weight-loss surgery. Her commitment to her patients’ success is unmistakable as she talks about individual lives, families, careers, and journeys—much more than numbers on a scale.
Q: First, the obvious question—why did you choose to specialize in bariatric surgery?
A: Obesity is an American crisis, and the epidemic is not slowing down. The burden that excess weight places on every organ in the body increases your risk for diabetes, heart disease, kidney disease, cancer, and more. Ultimately it shortens lives, but along the way it can take-away the life you enjoy. In my training, I came to realize that surgery was a powerful tool in obesity treatment. For many, it’s a life-changing option.
Q: Can you describe your discussion with a new patient about whether bariatric surgery is the right choice?
A: Our first appointment is a “getting to know you” exchange. I ask questions about my patient’s health history in general and the history of his or her obesity problem. My patient learns about what obesity surgery can offer and what commitment it requires. I want to be clear that weight-loss surgery may be the necessary step to help my patient regain control of his or her health. But it is a serious decision, requiring a life-long commitment to lifestyle changes and adjustments.
Q: Besides a strong personal commitment, what other factors determine whether someone is a candidate for bariatric surgery?
A: Any decision to have surgery balances benefits against risks. When body mass index (BMI) is above 40, it is likely that the health risk caused by obesity justifies the choice of surgery. Patients with a BMI of 35 or greater—with other obesity-related health conditions (obstructive sleep apnea, severe arthritis, hypertension and diabetes) also meet this qualification. Patients whose BMI is between 30 and 35 may qualify for a specific type of weight-loss procedure. Besides selecting patients for whom benefits outweigh risks, these guidelines generally determine whether health insurance will cover the surgery. A surgery candidate should also:
- be able to demonstrate that traditional weight loss programs have not been successful.
- be ready to commit to healthy lifestyle changes.
- understand the risks and rewards of weight loss surgery.
Q: Which specific bariatric procedures do you perform, and how do you advise patients about the choice of procedures?
A: Over time, surgeons have developed several different bariatric surgery techniques. Procedures differ in how they produce weight loss. Surgery may simply reduce the stomach’s size, or it may change the digestive process, making it harder for the digestive tract to absorb calories. You can read more about specific types of surgery on my website. I recommend the specific procedure best suited to each patient’s individual situation.
Bariatric surgery is usually a minimally-invasive procedure. It does not require a large incision. Instead, we use tiny microscopes and cameras to see inside, and tiny instruments passed through slender tubes to complete the surgery.
Q: What results can someone expect from bariatric surgery?
A: Dietary changes, increased physical activity and behavior changes can help you lose weight. Unfortunately, once someone becomes severely obese (BMI > 35), there is only a 5% chance that they will be able to successfully lose and maintain their weight loss with diet and exercise alone. Weight-loss surgery may be the best option to treat serious obesity. Weight loss surgery is recognized by The National Institutes of Health (NIH) as the only effective form of long-term weight loss for severely or morbidly obese patients.
How much and how quickly weight is lost varies individually, but expectations fall within the range of 60 to 80% of your excess weight. Our patients’ weight loss experience is a journey, where commitment to the long-term plan (diet and physical activity) shapes the path they travel and the destination they reach. The amazing patient testimonials on our website show—not what is typical—but rather, how personal the journey is.
The success of bariatric surgery is usually measured in numbers on the scale. But doctors want to know whether the pounds lost lead to measurable changes in health and longevity. New research published this fall in the Journal of the American Medical Association provides strong evidence that “weight-loss surgery can lower rates of heart attack, heart failure, atrial fibrillation and stroke, and lower death rates from any cause in a large group of at-risk patients.” (summarized in Time).
Q: Does insurance cover weight-loss surgery?
A: The majority of insurance policies now cover bariatric surgery and follow up care. You should contact your specific insurance company to see if your policy covers you and what requirements must be met. If you have difficulty obtaining this information, please call us and we will assist you.
Q: You emphasize the serious consideration that a decision about weight-loss surgery requires. How can one of our patients get more information to help her with such an important decision?
A: I am very pleased with the support that Brookwood provides individuals first considering bariatric surgery. I offer an information session twice monthly on the Brookwood campus. I would encourage patients to attend one of these sessions. The sessions are free but pre-registration is required. https://www.brookwoodbaptisthealth.com/events#1266
Thank you, Dr. Askew!